- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,396.76 / $12,339.70 / $19,868.50
| Facility | | $5,396.76 | $12,339.70 | $19,868.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,588.37 / $9,588.37 / $11,067.62
| Facility | | $9,588.37 | $9,588.37 | $11,067.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,837.00 / $18,017.56
| Facility | | $1,474.01 | $6,837.00 | $18,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,932.36 / $12,901.95 / $18,277.16
| Facility | | $8,932.36 | $12,901.95 | $18,277.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,807.86 / $10,821.22 / $22,725.90
| Facility | | $7,807.86 | $10,821.22 | $22,725.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,218.20 / $10,522.66 / $19,509.39
| Facility | | $7,218.20 | $10,522.66 | $19,509.39 |